left or right jugular constriction?

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

left or right jugular constriction?

Postby gibbledygook » Wed Sep 08, 2010 7:18 am

Which was more severely constricted, your left or right jugular vein? My left was worst. It seems like in Taiwan they also have worse left jugulars.

Ultrasound Med Biol. 2010 Aug 27. [Epub ahead of print]

Jugular Venous Hemodynamic Changes with Aging.
Chung CP, Lin YJ, Chao AC, Lin SJ, Chen YY, Wang YJ, Hu HH.

Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan.


Abstract
Cerebral venous outflow insufficiency via the internal jugular vein (IJV) is associated with several neurological disorders. However, a normal reference set of IJV hemodynamic parameters derived from a large, healthy population over a wide range of age has, until now, been lacking. Color-coded duplex sonography was performed on the IJVs of 349 subjects (55.60 +/- 17.49,16 to 89 y; 167 M/182 F). With increasing age, increased lumen area and decreased time-averaged mean velocity of bilateral IJV and a decreased proportion of total flow volume, drainage in the left IJV were found. The frequency of left jugular venous reflux (JVR) also increased with aging. We report IJV hemodynamic parameters across a large population, which could be used as a normal reference for clinical and research purposes. Furthermore, we found a decreased proportion of venous drainage, increased JVR prevalence, dilated lumen and slowed flow velocity in the left IJV, all of which suggest increased left IJV outflow impedance with aging. (E-mail: hhhu@vghtpe.gov.tw).

PMID: 20800950 [PubMed - as supplied by publisher]
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
User avatar
gibbledygook
Family Elder
 
Posts: 1414
Joined: Mon Feb 14, 2005 4:00 pm
Location: London

Advertisement

Postby cheerleader » Wed Sep 08, 2010 7:44 am

Gibs--
thanks for this paper. Dr. Chung continues to look at IJV reflux, outside of the CCSVI researchers. He's the doctor responsible for the transient global amnesia studies. The fact that he is correlating jugular reflux to aging might be part of the puzzle as to continued MS progression. And the fact that outflow decreases with age, again might be important.

From what I've learned, the left jugular vein is often smaller than the right in many people. Jeff's left side has closed again, and his collateral is back--but what is different than his pre-angio days is that he has a fully functioning right IJV, rather than one w/80% constriction. So he's still free from MS fatigue and heat intolerance. Maybe for him, one good side is enough?

Further study of left/right prevalence is needed....
Hope you're enjoying your new son, and doing OK,
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
User avatar
cheerleader
Family Elder
 
Posts: 5050
Joined: Mon Sep 10, 2007 3:00 pm
Location: southern California

Postby ErikaSlovakia » Wed Sep 08, 2010 8:18 am

cheerleader wrote:Further study of left/right prevalence is needed....

Yes.
Dr. Simka says in his not published paper abou right/left this:
"Also, we demonstrated (Fig. 5 and 6) that venous malformations were more often found on the left side. The prevalence of malformed left internal jugular vein was 83% vs. 74% of pathologic right internal jugular veins. Similarly, the blockages were found only in left, and not right, brachiocephalic vein. Currently, it is suspected that CCSVI is a congenital venous malformation. Taking into account embryologic development of these veins, (11) one should expect a higher prevalence of pathologies on the left side, which has actually been found in our study."
Erika
Aug. 7, 09 Doppler Ultras. in Poland, left Jugul. valve problem, RRMS since 1996, now SPMS,
- Nov.3,09: one stent in the left jug. vein in Katowice, Poland, LDN, never on DMDs
- Jan. 19, 11: control venography in Katowice - negative but I feel worse
ErikaSlovakia
Family Elder
 
Posts: 1123
Joined: Wed Jul 29, 2009 3:00 pm
Location: Slovakia, Europe

Postby gibbledygook » Wed Sep 08, 2010 8:23 am

Good for Jeff. I hope that he continues to be symptom free but the fact that he has renewed constriction doesn't sound good. I wonder if the proximity to the heart has an impact on left jugular reflux/stenosis...?

I'm having such a wonderful time with Arthur, now 10.8 weeks. He is growing rapidly and smiling and laughing lots. 8)
My MS symptoms are much, much better and I can walk down the corridor without stumbling so much, thank goodness. Also the myclonus and bladder are back to their post-stent improvements. I think that there is a strong probability that low blood pressure and the other vascular changes of pregnancy were quite extreme in me which would explain my pregnancy deterioration.
I can't wait till I return to California. But it will be in a couple more years, I expect.
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
User avatar
gibbledygook
Family Elder
 
Posts: 1414
Joined: Mon Feb 14, 2005 4:00 pm
Location: London

Postby gibbledygook » Wed Sep 08, 2010 8:38 am

Aha! Good info, Erika!
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
User avatar
gibbledygook
Family Elder
 
Posts: 1414
Joined: Mon Feb 14, 2005 4:00 pm
Location: London

Postby Rokkit » Wed Sep 08, 2010 9:18 am

gibbledygook wrote:I'm having such a wonderful time with Arthur, now 10.8 weeks. He is growing rapidly and smiling and laughing lots. 8)
My MS symptoms are much, much better and I can walk down the corridor without stumbling so much, thank goodness. Also the myclonus and bladder are back to their post-stent improvements. I think that there is a strong probability that low blood pressure and the other vascular changes of pregnancy were quite extreme in me which would explain my pregnancy deterioration.

This is all exceedingly wonderful news, Alex!
Rokkit
Family Elder
 
Posts: 669
Joined: Tue May 19, 2009 3:00 pm

Postby CureIous » Wed Sep 08, 2010 6:42 pm

Left, hands down. Got enough flow on the right now to handle 3 of the lefts, makes the Chunnel look small...
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
User avatar
CureIous
Family Elder
 
Posts: 1210
Joined: Tue Jul 14, 2009 3:00 pm
Location: Riverside, CA

Postby Ali888 » Wed Sep 08, 2010 6:54 pm

My left and right were both stenosed...right worse than left. I also had problems with the azygus. My husband had stenosis of the right jugular, not the left. His azygus was his main problem.
User avatar
Ali888
Family Member
 
Posts: 46
Joined: Thu Mar 18, 2010 4:00 pm
Location: Winnipeg, MB Canada

Postby smokey » Wed Sep 08, 2010 7:05 pm

Left. Totally. Right and Azygos fine.
User avatar
smokey
Family Member
 
Posts: 93
Joined: Sun Mar 21, 2010 4:00 pm

Postby Johnson » Thu Sep 09, 2010 1:11 am

I was quite severely stenosed both left and right. Dr. Simka said that he thought the left would need a stent, but they didn't put one in. My azygous seemed okay, but they said something about a bend.

I think that the a stenosis provokes, or precedes another, and another. For instance, I started having problems with CVI in my right leg at about the same time that the never-remitting relapse started in 2009 after a dental anaesthetic. My own, lay feeling is that CCSVI causes most of the "MS" symptoms, in most PwMS but something else is causing the stenoses. Doctors tend to know quite a bit more than I do in their fields, I just muse about such things. I felt brilliant after venoplasty, but things regressed pretty quickly It was not placebo. I don't think that it was the Fraxiparine either, as I felt just a couple of days later that things were closing up again. Maybe the massive doses of pre-procedure blood thinners that took a few days to metabolize? No, it was the stenoses that caused the symptoms. I'll let you know when I go back for another round nest month.

I'm sorry to hear of Jeff's development - but glad to hear that he is asymptomatic. Is it in/at the stent that it is restenosing? Or is it in another area of the vein? Will it be left untreated? Wait and see?

Congratulations to you and Wee Prince Arthur, Gibbledy. I'm just the Da with MS, I can't imagine doing the mother part. I couldn't do it. My hat is off to you.
My name is not really Johnson. MSed up since 1993
User avatar
Johnson
Family Elder
 
Posts: 979
Joined: Tue Dec 01, 2009 4:00 pm
Location: Ucluluet, BC

Postby Blaze » Thu Sep 09, 2010 5:39 am

I'm really interested in what everyone is saying. I haven't had a venogram or angioplasty yet, but my MRV and Doppler US showed the opposite of what most of you have found.

The MRV showed my right jugular was small while the left was large. The tech who did the Doppler and the physician who interpreted did not see the results of the MRV. They found right jugular completely blocked, left partially blocked with reflux.

Does the blockage affect which side of the body has more prominent MS symptoms? For those whose blockages are on the left, are your MS symptoms more prominent on the left or on the right?

My MS symptoms are far more prominent on my right side. My neurologist points out to me the left side of the brain controls to right side of the body and uses this to discredit CCSVI and the Doppler results. My family physician has also told me it is normal for the right jugular vein to be smaller than the left.

Like Not Johnson and others, I'm disappointed to hear of Jeff's developments, but glad his symptoms continue to be under control. Great to hear wee Arthur is doing well. Good news is always an uplifter.
User avatar
Blaze
Family Elder
 
Posts: 405
Joined: Sun Jun 27, 2010 3:00 pm

Postby bluesky63 » Thu Sep 09, 2010 6:32 am

So glad to hear that Arthur is doing well! Any age can be fun, but round about three months is wonderful with babies -- you will love this time period. :-)

Left stenosis worse than right for me, both sides stenosed, plus azygous. Right side symptoms worse.

I am sorry to hear of anyone feeling any symptoms and hope that every single thing we do here, every post, every procedure, all of it together will bring us all closer to solving this mystery. I am amazed at how much closer we are than we were a year ago, five years ago -- imagine five years from now! When baby Arthur is ready for school! :-)
User avatar
bluesky63
Family Elder
 
Posts: 441
Joined: Mon Apr 18, 2005 3:00 pm

Postby cheerleader » Thu Sep 09, 2010 7:52 am

From Gray's Anatomy--

At the root of the neck the right internal jugular vein is placed at a little distance from the common carotid artery, and crosses the first part of the subclavian artery, while the left internal jugular vein usually overlaps the common carotid artery. The left vein is generally smaller than the right, and each contains a pair of valves, which are placed about 2.5 cm. above the termination of the vessel.


Doctors typically do procedures on the right side (measure venous pulse, place catheters, endovascular procedures), since it is usually larger, but there are variants.

We studied 14 females and 11 males with an average age of 46 ± 12.9 years and average heights and weights of 168.1 ± 10.5 cm and 81.1 ± 16.1 kg. Indications for surgery included tumor, aneurysm and arteriovenous malformation. The right internal jugular vein was larger than the left in 19 patients (76.0%), the 2 veins were equal in size in 2 patients (8.0%) while the left was larger in 4 patients (16.0%). Overall, the average diameter of the right internal jugular vein was larger than the left, 1.48 ± 0.39 cm vs 1.12 ± 0.36 cm (p = .001). On angiography, the right jugular bulb was dominant in 11 patients (44.0%), jugular bulb drainage was deemed equal in 10 patients (40%) and the left jugular bulb was dominant in 4 patients (16%). In comparing ultrasound to angiography, the 4 patients with larger veins on the left had left dominant cerebral drainage while the 2 patients with equal veins had equal cerebral drainage. Of the 19 patients whose right internal jugular veins were larger, 11 patients had a right dominant jugular bulb while the remaining 8 patients had equal drainage (table 1). In the 15 patients who had a dominant jugular bulb, ultrasound predicted the dominant side with 100% sensitivity and specificity.

link

Thanks for Dr. Simka's information on this, Erika. Seems to be a pattern for many, not all.

Jeff's presenting issues of his first MS flare were on his left side. His left jugular was a thread and his right was also 80% closed when Dr. Dake saw him. The right is now open (like CureIous) and because of the difference, he has tinnitus (a whoosing sound when lying down) and can get postural headaches. We are waiting for further evaluation, because there may be nothing left to do for that left side--short of vein surgery. The vein is scrawny and defers to a larger collateral. BUT he is much better with one good side. He sleeps deeply, dreams again, no urgent bladder, no MS fatigue, he's active and involved in life and work again. He says this has all been worth it, because he is able to enjoy living again...and that was not the case prior to angio.

So glad to hear you're better than during pregnancy, Gibbs...we were all worried. Babies are the best. Now that my kid is six feet tall and shaving, I look back on those days fondly. Precious time.
Bluesky--you're right, we are getting there.
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
User avatar
cheerleader
Family Elder
 
Posts: 5050
Joined: Mon Sep 10, 2007 3:00 pm
Location: southern California

Postby Rokkit » Thu Sep 09, 2010 8:11 am

Technically my left was a little worse than my right in terms of stenosis, but not enough to get excited about. Both were pretty bad.
Rokkit
Family Elder
 
Posts: 669
Joined: Tue May 19, 2009 3:00 pm

Postby Kathyj08 » Thu Sep 09, 2010 9:34 am

My right was worse than my left. All 3 needed ballooning. My symptoms are mild (but many) and symptoms a little more noticable on the left. Also have pulsatile tinnitis in left ear mostly when laying down. Getting checked next week to see if I have re-stenosed.

Kathy
User avatar
Kathyj08
Family Member
 
Posts: 74
Joined: Fri Jan 08, 2010 4:00 pm
Location: Indiana, USA


Return to Chronic Cerebrospinal Venous Insufficiency (CCSVI)

 


  • Related topics
    Replies
    Views
    Last post

Who is online

Users browsing this forum: No registered users


Contact us | Terms of Service